| NPI | 1316107402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 016860) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 002867) |
| 103TC0700X Psychologist, Clinical (Licence: CT 002867) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2021-12-06 |